What is a Fasciotomy Procedure?

A fasciotomy is a procedure where a surgeon cuts your fascia to relieve compartment syndrome. Your fascia is a thin sheet of connective tissue surrounding and supporting your muscles.

Compartment syndrome is a potentially serious condition that occurs when pressure inside a muscle reaches a dangerous level. This pressure can compress the blood vessels that supply your muscles with blood. If it comes on quickly, people often experience severe pain and may have permanent muscle damage.

During a fasciotomy, a surgeon cuts the fascia around your muscle to relieve pressure.

Read on to learn more about what a fasciotomy entails, including the procedure and potential complications.

What causes the need for a fasciotomy?

Fasciotomy is a treatment for compartment syndrome . Compartments are groups of muscles, nerves, and blood vessels in your arms and legs. For example, the anterior compartment of your lower leg contains the muscles and structures found next to your shin bone.

Compartment syndrome can occur in any compartment but is most common in the front of your lower leg. It’s divided into two subtypes:

• Acute compartment syndrome: This is when it develops suddenly, often due to a traumatic injury. It’s usually extremely painful and is a medical emergency.
• Chronic compartment syndrome: This is when it develops slowly, often due to athletic activities. It’s usually not an emergency and often improves with rest.

Compartment syndrome often develops after:

• a sudden impact injury
• surgery to repair a fracture
• a blood vessel blockage caused by a clot or pressure on your arteries
• prolonged immobility

A fasciotomy allows doctors to relieve pressure inside your muscle so it can regain its blood flow.

Fasciotomy complications and risks

A fasciotomy can prevent severe compartment syndrome complications, like amputation or even death. However, like all surgeries, it can lead to complications. Wound complications can include :

• the need for a skin graft
• scarring
• infections
• tendon problems
• muscle herniation
• swelling
• recurrent ulcers
• discolored wounds
• itchy skin
• dry skin
• altered sensation around your wound

People who require a fasciotomy have a high risk of rhabdomyolysis and acute kidney failure due to muscle tissue death.

Other complications include:

• a long hospital stay
• nerve damage
• delayed bone healing
• chronic pain
• chronic venous insufficiency

If your surgery isn’t successful, you might need a second surgery.

How effective is a fasciotomy for compartment syndrome?

Acute compartment syndrome can be a serious condition that comes with a risk of death or a need for amputation . Receiving a prompt fasciotomy can help prevent these complications.

Surgical fasciotomy is the only effective treatment for severe acute compartment syndrome.

People who undergo a delayed fasciotomy have twice the amputation risk and three times the death rate as people who receive prompt treatment.

Fasciotomy procedure

Here’s a general idea of what you can expect before, during, and after a fasciotomy.

Before the procedure

A surgeon often performs a fasciotomy as an emergency surgery. When you reach a hospital, a surgical team will administer general anesthesia if there’s time. General anesthesia puts you asleep during the procedure and may be administered through a mask or intravenously (through an IV).

If there isn’t time to administer general anesthesia, you may receive a regional anesthetic to block pain in the part of your body the surgeon is treating.

During the procedure

During a fasciotomy, a surgeon will make an incision through your fascia to relieve pressure on the muscle. Here’s an example of what might happen to relieve pressure in a muscle in your lower leg:

1. Your surgeon will make one or more long incisions along the side of your lower leg.
2. They’ll cut through fat tissue to expose the underlying fascia.
3. They’ll make several long incisions along each fascia compartment to relieve the pressure.
4. Your wounds may be left open to prevent pressure from building up again. They might close it with stitches days later .

After the procedure

You’ll wake up in a recovery area at the hospital after your procedure. You’ll likely be connected to machines measuring your vitals, and you’ll have to undergo regular testing to monitor your condition before you’re discharged from the hospital.

Preparing for a fasciotomy

If a surgeon performs the fasciotomy as an emergency surgery, you won’t have time to prepare. If it’s planned, a doctor will likely tell you to stop eating and drinking hours in advance. They may also tell you to stop taking medications or supplements that thin your blood.

Fasciotomy recovery

Your recovery depends on the severity of your compartment syndrome and how quickly you received treatment. Wound closure usually occurs between 5 days and 3 weeks after your procedure.

In a 2024 study, researchers found the average length of a hospital stay for people who received a fasciotomy for upper extremity acute compartment syndrome within less than 6 hours was about 9 and a half days .

It can often take weeks or months for your nerves and muscles to recover fully.

Are there any alternatives to fasciotomy?

You may not need a fasciotomy if your condition is chronic and minor. Other treatments include:

• injections of botulinum toxin
• biomechanical changes for athletes
• physical therapy
• athletic taping
• stopping aggravating activities

How much does a fasciotomy cost?

The price of a fasciotomy can vary widely based on factors, like:

• whether you’re receiving emergency surgery
• the body part treated
• where you live
• the hospital or surgical center you visit

To give you a general idea, the nonprofit FairHealth Consumer estimates that 80% of procedures to make multiple incisions of connective tissue of the thigh or knee to relieve pressure in Bismark, North Dakota cost less than $2,429 without insurance. Possible additional costs may include:

• $909 for anesthesia
• $4,107 for surgery center
• $5,969 for hospital outpatient

Frequently asked questions about fasciotomy

Here are answers to some frequently asked questions people have about fasciotomies.

How risky is a fasciotomy?

A fasciotomy comes with a risk of complications, like nerve damage. However, the risk of not performing the surgery is often higher. Compartment syndrome can lead to life threatening complications.

Does the fascia grow back after a fasciotomy?

Your fascia usually repairs itself after the procedure. But sometimes, the tissue may not be able to repair itself or might not repair itself properly.

Takeaway

A fasciotomy is a surgery to treat compartment syndrome. It involves making incisions in your facia to relieve pressure in your muscles.

If left untreated, acute compartment syndrome can cause life threatening complications. Receiving a fasciotomy can minimize your chances of severe complications.